Yang Pengli, Xue Rui, Wei Yuhang, Cao Chenxi, Yu Songcheng, Peng Shanling, Zhang Wenjing, Wang Yunzhe, Zheng Yingying, Liu Gangqiong
Department of Cardiology, Key Laboratory of Cardiac Injury and Repair of Henan Province, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Medical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China.
Front Cardiovasc Med. 2024 Dec 20;11:1418781. doi: 10.3389/fcvm.2024.1418781. eCollection 2024.
The aim of this study was to explore the predictive value of the Systemic Inflammatory Response Index (SIRI) for the prognosis of older postmenopausal women with coronary artery disease (CAD).
This retrospective cohort study included 617 postmenopausal female patients aged 50 years or older with a CAD diagnosis confirmed by coronary angiography seen at the First Affiliated Hospital of Zhengzhou University from January 2019 to December 2020. Patients were divided into three groups based on SIRI tertiles. Primary endpoints were all-cause mortality (ACM) and cardiac mortality (CM), and secondary endpoints were major adverse cardiovascular events (MACEs) and major adverse cardiovascular and cerebrovascular events (MACCEs).
The frequencies of all adverse outcomes were greater in the high level (third tertile) SIRI group than in the low level (first tertile) SIRI group. Multivariable regression analysis showed that compared to the low level SIRI group, the high level SIRI group had a 1.581-fold greater risk of ACM [hazard ratio (HR) = 2.581, 95% confidence interval (CI): 1.045-6.373, = 0.040) and a 1.798-fold greater risk of CM (HR = 2.798, 95% CI: 0.972-8.060, = 0.057). In addition, the risks of MACEs and MACCEs were 62.3% (HR = 1.623, 95% CI: 1.123-2.346, = 0.01) and 55.8% (HR = 1.558, 95% CI: 1.100-2.207, = 0.012) greater in the high level SIRI group compared with the low level SIRI group. Kaplan-Meier survival analyses confirmed that the high SIRI level was associated with increased risks of ACM ( = 0.001), CM ( = 0.005), MACEs ( = 0.003), and MACCEs ( = 0.005).
This retrospective study demonstrates that the novel derived inflammatory index SIRI can effectively predict the risk of multiple adverse outcomes in postmenopausal women with CAD.
本研究旨在探讨全身炎症反应指数(SIRI)对老年绝经后冠心病(CAD)女性患者预后的预测价值。
这项回顾性队列研究纳入了617例年龄在50岁及以上、2019年1月至2020年12月在郑州大学第一附属医院经冠状动脉造影确诊为CAD的绝经后女性患者。根据SIRI三分位数将患者分为三组。主要终点为全因死亡率(ACM)和心脏死亡率(CM),次要终点为主要不良心血管事件(MACE)和主要不良心血管和脑血管事件(MACCE)。
高水平(第三三分位数)SIRI组的所有不良结局发生率均高于低水平(第一三分位数)SIRI组。多变量回归分析显示,与低水平SIRI组相比,高水平SIRI组发生ACM的风险高1.581倍[风险比(HR)=2.581,95%置信区间(CI):1.045 - 6.373,P = 0.040],发生CM的风险高1.798倍(HR = 2.798,95% CI:0.972 - 8.060,P = 0.057)。此外,与低水平SIRI组相比,高水平SIRI组发生MACE和MACCE的风险分别高62.3%(HR = 1.623,95% CI:1.123 - 2.346,P = 0.01)和55.8%(HR = 1.558,95% CI:1.100 - 2.207,P = 0.012)。Kaplan - Meier生存分析证实,高SIRI水平与ACM(P = 0.001)、CM(P = 0.005)、MACE(P = 0.003)和MACCE(P = 0.005)风险增加相关。
这项回顾性研究表明,新得出的炎症指数SIRI可有效预测绝经后CAD女性患者发生多种不良结局的风险。